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Musculoskeletal Pain in Malaysia:
A COPCORD Survey
KIRAN VEERAPEN, RICHARD D. WIGLEY, and HANS VALKENBURG ABSTRACT. Objective. To assess the nature and extent of rheumatic complaints in a semirural area in a multiracial (Malay, Indian, Chinese) community in Malaysia using the Community Oriented Program for the Control of Rheumatic Diseases (COPCORD) protocol initiated by ILAR and the WHO. Methods. All members of a community of 2700 persons over the age of 15 years were offered a questionnaire based interview in Phase 1 of the study. Those with rheumatic complaints (pain in the last 1 week) were invited for a physical examination by a rheumatologist in Phase 2. Results. In total, 2594 (96%) persons agreed to a questionnaire based interview. Of those interviewed, 21.1% had a current rheumatic complaint. The pain rate was higher in women (23.8%) than in men (17.8%). Chinese men had the lowest age-standardized pain rate (9.9%), while Indian women had the highest rate (28.4%). In the study population, 14.4% complained of pain in the joints and/or musculoskeletal pain and 11.6% had low back pain. The knee was responsible for 64.8% of all complaints pertaining to the joints, and more than half those examined with knee pain had clinical evidence of osteoarthritis (OA). The complaint rate increased with age, up to 53.4% in the group age > 65 years. The major disability encountered was the inability to squat (3.1%). Fibromyalgia, soft tissue lesions, and localized OA of the knees were the main clinical diagnoses. Inflammatory arthritis was uncommon. Both Western and traditional sources of healthcare were used, often together. Self-medication was common (58.8%). Conclusion. Knee and back pain are the main rheumatic complaints in Malaysia, with complaint rates differing according to race and gender. (J Rheumatol 2007;34:207–13) Key Indexing Terms:
MUSCULOSKELETAL PAIN From the University of Malaya Medical Centre, Kuala Lumpur, Malaysia; the World Health Organization Centre for the Epidemiology of Rheumatic Disease, Public Hospital, Palmerston North, New Zealand; and Erasmus University, Rotterdam, The Netherlands. Supported by Pharmacia International, Pfizer Private Ltd., May & Baker (Malaysia) Sdn Bhd, and Roche (Malaysia) Sdn Bhd. K. Veerapen, MBBS, FRCP(Edin), PG Dip Med Ed (Dundee), University of Malaya Medical Centre; R.D. Wigley, MB, ChB, FRCP, WHO Centre for the Epidemiology of Rheumatic Disease; H. Valkenburg, MD, PhD, Erasmus University. Prof. Valkenburg is deceased. Address reprint requests to Dr. K. Veerapen, 4913 Wesley Road, Victoria, British Columbia V8Y 1Y8, Canada. E-mail: kveerapen@shaw.ca Accepted for publication September 8, 2006. |
